Defining Health and Illness: Concepts and Models
With Sophie and Theo, Sociology & Mental Health Specialist
Key Takeaways
- How we define health shapes what we notice, ask about, and respond to.
- A midwife working only with a biomedical definition might miss a woman who is physically well but socially isolated, financially stressed, and psychologically struggling.
- The 1948 WHO definition says health is complete physical, mental, and social wellbeing — not merely absence of disease.
- It was revolutionary in expanding health beyond the biomedical.
- The biomedical model focuses on biological causes — pathology, disease, measurable dysfunction.
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Full Transcript
Sophie: Today we're exploring how we define health and illness, and why that matters in midwifery. I'm Sophie, and joining me is Theo, our Sociology and Mental Health Specialist. Theo, why does the definition of health matter practically for midwives?
Theo: How we define health shapes what we notice, ask about, and respond to. A midwife working only with a biomedical definition might miss a woman who is physically well but socially isolated, financially stressed, and psychologically struggling.
Sophie: Let's start with the WHO definition — what does it say and why is it significant?
Theo: The 1948 WHO definition says health is complete physical, mental, and social wellbeing — not merely absence of disease. It was revolutionary in expanding health beyond the biomedical. The challenge is that complete wellbeing is rarely achieved, making it aspirational.
Sophie: What is the biomedical model and what are its limits in midwifery?
How does defining health and illness: concepts and models work in a healthcare context?
Theo: The biomedical model focuses on biological causes — pathology, disease, measurable dysfunction. It is powerful for diagnosis but does not account for psychological, social, or cultural dimensions of a woman's experience of pregnancy and birth.
Sophie: How does the biopsychosocial model address those limits?
Theo: Engel's biopsychosocial model integrates biological, psychological, and social factors simultaneously. For midwives it is far more useful — a woman's pain in labour, her readiness to breastfeed, her postnatal mental health — all involve all three dimensions.
Sophie: What is the difference between illness and disease?
Theo: Disease is an objectively identifiable pathological process. Illness is the subjective experience — how the person feels and what it means to them. A woman can have gestational hypertension she has not felt, or feel profoundly unwell with no detectable pathology.
How does defining health and illness: concepts and models work in a healthcare context?
Sophie: How do social determinants of health play out in the women midwives care for?
Theo: Income, housing, education, ethnicity, and social support are among the strongest predictors of birth outcomes. Women in deprivation have higher rates of preterm birth and maternal mortality. Asking about social context is clinical assessment, not social work.
Sophie: Health is much bigger than a blood pressure reading. Thank you, Theo.
Theo: Midwifery has always understood this intuitively. These frameworks give that understanding the language and structure it deserves.